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<head>
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	<title>aXis - ADD RESIDENT</title>
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	<script type="text/javascript" src="<?php echo base_url();?>application/js/onsubmitform-addresidentview.js"></script>
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	<script type="text/javascript" src="<?php echo base_url();?>application/js/jquery-std.js" ></script>			
</head>

<body>
<a id="myAnchor" href=""></a>
<div class="demo">	
	<div id="header"><h1>ACCI eXtreme Information System</h1></div>
	<a id="errorMessage"></a>
	<div id="accordion" >
	
		<h3><a href="#section1">Add a Resident</a></h3>
		<form name="adminform" method="post" onsubmit="return OnSubmitForm();">
		<div id="student_number_box" class="everyInfoBox">
		   <div class="everyInfoSubBox" id="student_number_warning_box">
		   </div>
		   <div class="everyInfoSubBox">
		    	<input type="text" name="student_number" maxlength="10" class="dataProperties"  />
		   </div>
		   <div class="everyInfoSubBox-Leftmost" >
		   		Student Number: 
		   </div>
		   
		</div>	
		<div id="fname_box" class="everyInfoBox">
		   <div class="everyInfoSubBox" id="first_name_warning_box">
		   </div>
		   <div class="everyInfoSubBox">
		    	<input type="text" name="first_name" maxlength="100" class="dataProperties"  />
		   </div>
		   <div class="everyInfoSubBox-Leftmost">
		   		First Name: 
		   </div>
		   
		</div>	
		<div id="mname_box" class="everyInfoBox">
		   <div class="everyInfoSubBox" id="middle_name_warning_box">
		   </div>
		   <div class="everyInfoSubBox">
		    	<input type="text" name="middle_name" maxlength="100" class="dataProperties" />
		   </div>
		   <div class="everyInfoSubBox-Leftmost">
		   		Middle Name: 
		   </div>		   
		</div>	
		<div id="lname_box" class="everyInfoBox">
		   <div class="everyInfoSubBox" id="last_name_warning_box">
		   </div>
		   <div class="everyInfoSubBox">
		    	<input type="text" name="last_name" maxlength="100" class="dataProperties"  />
		   </div>
		   <div class="everyInfoSubBox-Leftmost">
		   		Last Name: 
		   </div>		   
		</div>
		<hr />
		<div class="everyInfoBox">
		   <div class="everyInfoSubBox-1">
		   		Gender:&nbsp;&nbsp;&nbsp; <select name="gender">
				<option selected="selected" value="Female">Female</option>
				<option>Male</option>
				</select>
		   </div>
		   <div class="everyInfoSubBox-1">
		    	Civil Status:&nbsp; 		   
		    	<select name="civil_status">
				<option selected="selected">Single</option>
				<option>Married</option>
				<option>Divorced</option>
				<option>Separated</option>
				<option>In a Relationship</option>
				<option>It's Complicated</option>
				<option>Not Applicable</option>
				</select>
		   </div>		   		   
		</div>
		<br/>
		<div id="birthday_box" class="everyInfoBox">
		   <div class="everyInfoSubBox" id="birthday_warning_box">
		   </div>
		   <div class="everyInfoSubBox">
		    	<input type="text" name="birthday" id="datepicker" class="dataProperties" />	
		   </div>
		   <div class="everyInfoSubBox-Leftmost">
		   		Birthday: 
		   </div>		   
		</div>			
		<div id="religion_box" class="everyInfoBox">
		   <div class="everyInfoSubBox" id="religion_warning_box">
		   </div>
		   <div class="everyInfoSubBox">
		    	<input type="text" name="religion" maxlength="200" class="dataProperties"  />
		   </div>
		   <div class="everyInfoSubBox-Leftmost">
		   		Religion: 
		   </div>
		   
		</div>
		<hr />
		<div id="course_box" class="everyInfoBox">
		   <div class="everyInfoSubBox" id="course_warning_box">
		   </div>
		   <div class="everyInfoSubBox">
		    	<input type="text" name="course" maxlength="15" class="dataProperties"  />
		   </div>
		   <div class="everyInfoSubBox-Leftmost">
		   		Course (Degree): 
		   </div>
		   </div>
		   <div id="college_box" class="everyInfoBox">
		   	<div class="everyInfoSubBox" id="college_warning_box">
		   	</div>
		  	 <div class="everyInfoSubBox">
		    	<select name="college" class="dataProperties">				
				<option selected="selected" value="CA">College of Agriculture (CA)
				</option>
				<option value="CDC">College of Development Communication (CDC)
				</option>
				<option value="CEM">College of Economics &amp; Management (CEM)
				</option>
				<option value="CEAT">College of Engineering &amp; Agro-industrial Technology (CEAT)
				</option>
				<option value="CFNR">College of Forestry &amp; Natural Resources (CFNR)
				</option>
				<option value="CHE">College of Human Ecology (CHE)</option>
				<option value="CVM">College of Veterinary Medicine (CVM)
				</option>
				<option value="CA-CAS">CA-CAS Joint Program</option>
				<option value="CAS">College of Arts &amp; Sciences (CAS)</option>
				</select>
		   	</div>
		  	 <div class="everyInfoSubBox-Leftmost">
		   		College: 
		   	</div>		   
		</div>
		<div id="classification_box" class="everyInfoBox">
		   <div class="everyInfoSubBox" id="classification_warning_box">
		   </div>
		   <div class="everyInfoSubBox">
		    	<select name="classification" class="dataProperties">
					<option>Freshman</option>
					<option>Sophomore</option>
					<option>Junior</option>
					<option>Senior</option>
					</select>

		   </div>
		   <div class="everyInfoSubBox-Leftmost">
		   		Classification: 
		   </div>		   
		</div>
		<div id="home_address_box" class="everyInfoBox">
		   <div class="everyInfoSubBox" id="home_address_warning_box">
		   </div>
		   <div class="everyInfoSubBox">
		    	<input type="text" name="home_address" class="dataProperties" />
		   </div>
		   <div class="everyInfoSubBox-Leftmost">
		   		Home Address: 
		   </div>		   
		</div>
		<div id="telephone_number_box" class="everyInfoBox">
		   <div class="everyInfoSubBox" id="telephone_number_warning_box">
		   </div>
		   <div class="everyInfoSubBox">
		    	<input type="text" name="telephone_number" class="dataProperties" />
		   </div>
		   <div class="everyInfoSubBox-Leftmost">
		   		Telephone Number: 
		   </div>		   
		</div>
		<div id="email_address_box" class="everyInfoBox">
		   <div class="everyInfoSubBox" id="email_address_warning_box">
		   </div>
		   <div class="everyInfoSubBox">
		    	<input type="text" name="email_address" class="dataProperties" />

		   </div>
		   <div class="everyInfoSubBox-Leftmost">
		   		Email Address: 
		   </div>		   
		</div>
		<div id="region_box" class="everyInfoBox">
		   <div class="everyInfoSubBox" id="region_warning_box">
		   		&nbsp;</div>
		   <div class="everyInfoSubBox">
		    	<select name="region" class="dataProperties" >
				<option selected="selected" value="NCR" id="NCR">National Capital Region (NCR)
				</option>
				<option value="1" id="1">Region 1 - Ilocs Region</option>
				<option value="2" id="">Region 2 - Cagayan Valley</option>
				<option value="3" id="3">Region 3 - Central Luzon</option>
				<option value="4A" id="4A">Region 4-A - CALABARZON</option>
				<option value="4B" id="B">Region 4-B - MIMAROPA</option>
				<option value="5" id="5">Region 5 - Bicol Region</option>
				<option value="6" id="6">Region 6 - Western Visayas</option>
				<option value="7" id="7">Region 7 - Central Visayas</option>
				<option value="8" id="8">Region 8 - Eastern Visayas</option>
				<option value="9" id="9">Region 9 - Zamboanga Peninsula</option>
				<option value="10" id="10">Region 10 - Northern Mindanao</option>
				<option value="11" id="11">Region 11 - Davao Region</option>
				<option value="12" id="12">Region 12 - SOCCSKSARGEN</option>
				<option value="CAR" id="CAR">Cordillera Administrative Region (CAR)
				</option>
				<option value="CARAGA" id="CARAGA">CARAGA Region</option>
				<option value="ARMM" id="ARMM">Autonomous Region of Muslim Mindanao (ARMM)
				</option>
				</select>

		   </div>
		   <div class="everyInfoSubBox-Leftmost">
		   		Region: 
		   </div>		   
		</div>
		<hr/>
		<div id="name_of_father_box" class="everyInfoBox">
		   <div class="everyInfoSubBox" id="name_of_father_warning_box">		   		
		   </div>
		   <div class="everyInfoSubBox">		    	
				<input type="text" name="name_of_father" class="dataProperties" />
		   </div>
		   <div class="everyInfoSubBox-Leftmost">
		   		Name of Father: 
		   </div>
		   
		</div>
		<div id="telnumber_of_father_box" class="everyInfoBox">
		   <div class="everyInfoSubBox" id="telnumber_of_father_warning_box">		   		
		   </div>
		   <div class="everyInfoSubBox">		    	
				<input type="text" name="telnumber_of_father" class="dataProperties" />
		   </div>
		   <div class="everyInfoSubBox-Leftmost">
		   		Contact Number: 
		   </div>
		   
		</div>
		<br/>
		<div id="name_of_mother_box" class="everyInfoBox">
		   <div class="everyInfoSubBox" id="name_of_mother_warning_box">		   		
		   </div>
		   <div class="everyInfoSubBox">		    	
				<input type="text" name="name_of_mother" class="dataProperties" />
		   </div>
		   <div class="everyInfoSubBox-Leftmost">
		   		Name of Mother: 
		   </div>
		   
		</div>
		<div id="telnumber_of_father_box" class="everyInfoBox">
		   <div class="everyInfoSubBox" id="telnumber_of_mother_warning_box">		   		
		   </div>
		   <div class="everyInfoSubBox">		    	
				<input type="text" name="telnumber_of_mother" class="dataProperties" />
		   </div>
		   <div class="everyInfoSubBox-Leftmost">
		   		Contact Number: 
		   </div>
		   
		</div>
		<br/>

		<div id="name_of_guardian_box" class="everyInfoBox">
		   <div class="everyInfoSubBox" id="name_of_guardian_warning_box">		   		
		   </div>
		   <div class="everyInfoSubBox">		    	
				<input type="text" name="name_of_guardian" class="dataProperties" />
		   </div>
		   <div class="everyInfoSubBox-Leftmost">
		   		Name of Guardian: 
		   </div>
		   
		</div>
		<div id="telnumber_of_father_box" class="everyInfoBox">
		   <div class="everyInfoSubBox" id="telnumber_of_guardian_warning_box">		   		
		   </div>
		   <div class="everyInfoSubBox">		    	
				<input type="text" name="telnumber_of_guardian" class="dataProperties"/>
		   </div>
		   <div class="everyInfoSubBox-Leftmost">
		   		Contact Number: 
		   </div>
		   
		</div>
		<br/>
		<div>			
			<center>
			<input type="reset"  value="Reset Fields" onclick="return OnSubmitForm(this.value)" />
				<input type="submit" value="Add Resident" onclick="document.pressed=this.value" />
				<a href="/axis/index.php/adminpagecontroller">
					<input type="button" value="Back to Main Menu" />
				</a>
			</center>
		</div>
		
		</form>		
	</div><!-- End accordion -->

</div><!-- End demo -->

</body>
</html>
